Individual provider Active NPI

Breanna Salazar, DPT

  • Physical Therapist
  • Florham Park, NJ
National Provider Identifier
1063968063
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4QA01689100 Issued in NJ
Practice address
140 Park Ave
Florham Park, NJ 07932-1049
Phone
(973) 285-7613
Fax
(973) 267-1716
NPI assigned
Aug 30, 2016
Last updated
Jul 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01689100 NJ
Physical Therapist 225100000X 4QA01689100 NJ Primary

Addresses

Primary practice location

140 Park Ave
Florham Park, NJ 07932-1049

Mailing address

50 Green LN
Randolph, NJ 07869-1101
Phone (201) 841-0686

Other practice location 1

200 S Orange Ave Ste 10
Livingston, NJ 07039-5817
Phone (973) 322-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161216000952 NJ Practitioner - Physical Therapist in Private Practice 3870873490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4QA01689100NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Jul 8, 2024 Accepting new patients
Summit Medical Group PA CurrentSince Jul 8, 2024 Accepting new patients
Summit Medical Group, Inc Past Accepting new patients

Locations

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

140 Park Ave
Florham Park, NJ 07932
Phone (973) 404-9700

Interoperability endpoints

  • Direct secure messaging: breanna.salazar.1@2983.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1063968063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 GREEN LN",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078691101",
            "telephone_number": "201-841-0686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 PARK AVE",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321049",
            "telephone_number": "973-285-7613",
            "fax_number": "973-267-1716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 S Orange Ave Ste 10",
            "address_purpose": "LOCATION",
            "city": "Livingston",
            "state": "NJ",
            "postal_code": "070395817",
            "country_code": "US",
            "telephone_number": "973-322-7500",
            "fax_number": "973-322-7545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALAZAR",
        "first_name": "BREANNA",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-30",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01689100",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "4QA01689100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florham Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.